Change Of Name Address Phone And Social Security Number - Houston Community College
ADVERTISEMENT
1date entered
Houston Community College
Change of name, address, phone, & soCial seCurity no.
soCial seCurity no.
CURRENT NamE
last
first
m.i.
Change of: (CheCk all appropriate)
❏ name
❏ phone
❏ address
❏ *social security no.
*to be made only by registrar’s office
soCial seCurity Change
preVious name
incorrect s.s. no.
name
last
first
m.i.
address Change
phone Change
new home address
new home phone
no.
street
apt. no.
city
state
zip
(area code)
in what school district do you reside? ❏ hisd
❏ stafford
❏ alief
❏ katy
new permanent phone
❏ cy-fair
❏ spring branch
❏ fort bend ❏ north forest ❏ other _ __________
new mailing address
(area code)
new work phone
no.
street
apt. no.
city
state
zip
* if your new address changes your residency status, you must complete a change of residency petition and submit supporting
documentation
e-mail address
(area code)
(extension)
signature
date
With few exceptions, state law gives you the right to request, receive, review and correct information about yourself collected on this form.
form no. 400 (rev.5/06)
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal